Provider Demographics
NPI:1235251703
Name:MARKS, IRENE (APN)
Entity Type:Individual
Prefix:MS
First Name:IRENE
Middle Name:
Last Name:MARKS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 S. MICHIGAN AVE.
Mailing Address - Street 2:UNIT #3
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616
Mailing Address - Country:US
Mailing Address - Phone:312-791-1078
Mailing Address - Fax:
Practice Address - Street 1:1901 W HARRISON ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3714
Practice Address - Country:US
Practice Address - Phone:312-864-0854
Practice Address - Fax:312-864-9580
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209004377363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health